By Katie Brown
Currently, more than two-thirds of the world’s population is without access to chiropractic care. According to statistics from the Chiropractic Diplomatic Corps, as of June 2011, there were approximately 82,000 reported DCs worldwide. However, with more than 60,000 reported DCs in the United States—that’s an estimated 75 percent of chiropractors worldwide who practice solely in America—there is an evident need for Chiropractic overseas.
From language barriers to financial restrictions, American chiropractors practicing abroad experience their fair share of challenges. Yet, with Chiropractic’s growing demand, especially in more remote areas and developing countries, many chiropractors are packing their bags and heading overseas to spread Chiropractic’s message.
Opportunities are far from scarce for DCs interested in a global experience. The Chiropractic Diplomatic Corps currently has projects in Asia, India and the Philippines, and Life University’s International Clinic Programs, which provide 14th quarter chiropractic students with the opportunity to further their clinical education in a unique, global environment, have clinics in China, Peru, New Zealand and Sweden.
And for DCs looking for a more spiritually driven experience abroad, the Christian Chiropractic Association (CCA) aims to provide the chiropractic profession with an opportunity for Christian fellowship and service through a variety of missions in countries like Honduras, Bolivia, Ethiopia, Poland and beyond. “Developing nations hold considerable attraction,” says Charlie Hollensed, D.C., president of CCA. “There’s little or no competition, lower overhead and a better lifestyle available with recreational opportunities and great weather, and [there’s the] chance to advance your profession and be a pioneer.”
While temporary and short-term assignments are available for chiropractors wanting to serve abroad, implementing a chiropractic lifestyle in many of these communities and countries is contingent upon the full-time work and dedication of pioneer DCs who create new practices in these areas. “Those DCs willing to plant roots have a clear track to follow by focusing on a specific population, the money to relocate, investment to set up a new practice and [creating] a suitable home,” says Michel Tetrault, D.C., executive director of Chiropractic Diplomatic Corps.
Tetrault also notes the importance of training a new generation of chiropractors. For DCs on short-term missions, it’s vital that veteran chiropractors include local chiropractors, especially during the implementation and planning phases of setting up a new clinic.
Likewise, there is also a need for chiropractors capable of teaching others their craft. “There will be a growing need for chiropractic educators as we see a large number of new DC schools in the coming decades,” says Tetrault. “True teachers are needed, not just someone who wants to teach to get a foreign experience.”
The Process Behind the Experience
While a getaway escape to an exotic location may seem like a relaxed excursion, the process and development behind many of these missions have taken years to implement. And for some of the international programs created through LIFE’s Global Initiatives program, it’s taken decades. “Institutional initiatives are a bit more cumbersome than an individual striking out to seek adventure or escape, and as an educational institution, there is a different level of protocol, process and planning,” says John Downes, D.C., executive director of international affairs and LIFE’s Global Initiatives. “There are initiatives that have been worked on for five to 10 years that may seem like they just came along through good fortune. Life University has been demonstrating Dr. Riekeman’s vision of sustainability, and that usually means more planning and persistence than may be expected.”
For students who partake in an excursion abroad through the Practice Excellence Art & Knowledge (PEAK) International program, which gives Life University students the opportunity to learn and share the chiropractic vision in countries like Peru, New Zealand and China, the selection process is highly competitive, since the student interns are expected to be not only ambassadors for the chiropractic profession, but qualified providers of chiropractic care as well. “For example, in China, with a population of 1.3 billion, there are approximately 20 chiropractors,” says Ralph Davis, D.C., dean of clinics for LIFE. “That means that one of our student interns will likely be the first contact a Chinese citizen has with the chiropractic profession—that is an awesome responsibility.
For that reason, the selection process to become a PEAK International intern is rigorous. “An interested student must have no honor code violations, meet established academic requirements, be involved and engaged in Life University activities, demonstrate a record of excellent patient care in the clinic system and successfully complete the application process that includes a videoconference interview with the extension faculty member at the international site.”
Overcoming Obstacles and Reaping the Reward
By looking at the staggering statistics alone, it’s easy to understand the need for Chiropractic overseas. However, laws and regulations have made it difficult for DCs wanting to serve abroad. “There are only 42 countries [that] currently have legal regulations on Chiropractic, so elsewhere, [chiropractors must adhere] to common business laws,” says Tetrault. “DCs traveling abroad must respect the legality of the local chiropractors and not violate local government immigration and labor laws by trying to practice ‘on the fly’ and illegally.”
Unfortunately, while Chiropractic is wholly accepted as a profession in some countries, its practice is punishable in others. “There are countries where Chiropractic is accepted, but where no regulation exists, like in Ghana,” says Downes. “But there are also countries like South Korea where DCs are going to jail, so you must know what you’re getting yourself into.”
Aside from the legality of practicing Chiropractic in certain areas, DCs can experience other difficulties abroad; however, most of these challenges are related to a person’s unfamiliarity with a new culture and its customs. “Obviously, cross-cultural challenges and the realities of living outside a Western country, with lower standards of living, are issues to confront, and don’t forget the language barriers, as well,” says Tetrault. “Mostly, the challenges come from [Chiropractic] being such a small profession in so many countries.”
Downes agrees that aside from a country’s regulations and recognition of Chiropractic, the majority of potential issues are internal, such as how well a person adapts to a non-American society and whether they can create a feeling of acceptance into the new community.
For DC students participating in the PEAK International program, one of their biggest obstacles is their reluctance to return home. “In general, students who participate in PEAK International say that the greatest challenge of the experience was the language barrier,” says Davis. “The second most common challenge for our students has been returning home at the end of the quarter because they fall in love with the people and the country in which they serve.”
However, regardless of possible legal and barrier issues, many chiropractors are compelled to serve beyond the people in their immediate communities. “There seem to be two driving forces—one is adventure and the other is escape,” says Downes. “By that I mean some see the world full of patients and want to spread the message of Chiropractic, and they see it as an adventure filled with challenges and rewards. Those driven by escape remember the days when Chiropractic was provided with genuine dedication and without the current trappings of insurance and regulations, and they have lost their joy, so the thought of going abroad is invigorating for them.”
With the PEAK International program, student interns have the opportunity early on in their chiropractic careers to hone their skills in unique, one-of-a-kind environments. “Studying abroad provides an opportunity for LIFE students to be immersed in a new culture and to appreciate the world’s diversity,” says Davis. “Most of all, the participants are given the opportunity to be ambassadors for Life University and the chiropractic profession.”
Ultimately, a chiropractor’s time abroad isn’t solely about the experience and skills he or she gains, but about spreading the chiropractic profession and the message of living a vitalistic lifestyle. “Chiropractic needs leaders willing to set aside their personal interests and focus on creating opportunities for international development—true commitment that goes beyond personal gratification,” says Tetrault. “One conclusion can be shared: Chiropractic is amazing and alive in the world.”